HCS Customer Service Specialist II (SCA)

Full Time

San Angelo, TX

Posted

Job description

Available for hire Teleworking in the following area/location: San Angelo, Texas (Tom Green, County) .

Customer Service Specialist II's (SCA)'s, are the primary points of contact for all providers, Medicare contractors, etc. They are to provide professional, accurate and timely responses to CMS and provider inquiries. This includes responding to written, telephonic, and electronic inquiries within the appropriate timeframes.

Essential duties:

Maintain a current knowledge of all contract requirements and objectives

Develop professional working relationships with colleagues, healthcare providers and other Medicare contractors

Take inbound calls from providers to answer questions and resolve complex issues

Make outbound calls to healthcare providers as a courtesy to confirm if letters requesting records for review have been received

Respond to assigned written communications from providers timely and accurately

Educate providers on proper process protocols and their appeal rights

Establish appropriate contacts and perform necessary research to validate provider contact information

Conduct critical due diligence follow-ups if additional research or action is required to resolve an inquiry

Enter and update all contact and activity information into tracking logs and the audit platform where not automatically completed by the system, e.g., a telephone call, correspondence responses, special notes, etc.

Research and route internal/external communications to the appropriate person or department

Notify management of:

all escalated displeasure with the audit program

legal action

government intervention

escalated concerns regarding audit issues and edit parameters

suggestions to improve or correct processes or documents

Maintain HIPAA Certification

Perform miscellaneous duties as assigned in a highly professional manner

Note - All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Performant’s policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination.

Required Skills and Knowledge:

Excellent verbal and written communication skills

Skilled in data entry and knowledge of computers

Working knowledge of Excel

Courteous, professional, and respectful attitude

Strong understanding of customer service policies and processes

Ability to learn CMS rules and regulations and understand the CMS Recovery Audit Contractor program

Healthcare and insurance terminology knowledge preferred but not required.

Flexibility to prioritize and handle non-standard situations that may arise

Must be detailed, organized and able to manage various job duties as required

Maintain a strong work ethic and attendance

Additional Requirements:

Ability to obtain and maintain client required clearances as well as pass company regular background and/or drug screening.

Completion of Teleworker Agreement upon hire, and adherence to the Agreement (and related policies and procedures) including, but not limited to: able to navigate computer and phone systems as a user to work remote independently using on-line resources, must have high-speed internet connectivity, appropriate workspace able to be compliant with HIPAA, safety & ergonomics, confidentiality, and dedicated work focus without distractions during work hours.

Physical Requirements:

Available for hire teleworking in the following area/location: San Angelo, Texas (Tom Green, County) .

**NOTE: Must be able to meet requirements for and perform work assignments in accordance with Company policies and expectations on a home remote basis (and must meet Performant remote-worker requirements) until at which time staff may be notified and required to work from a Performant office location on an ad-hoc or periodic basis.

Basic office equipment required to perform remote work is provided by the company.

Job is performed in a standard busy office environment with moderate noise level (or may be home-office setting subject to Company approval and Teleworker Agreement), sits at a desk during scheduled shift, uses office phone or headset provided by the Company for calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a mouse.

Reads and comprehends information in electronic (computer) or paper form (written/printed).

Sit/stand 8 or more hours per day; has the option to stand as needed while on calls; reach as needed to use office equipment.

Consistently viewing a computer screen and types frequently, but not constantly, using a keyboard to update accounts.

Consistently communicates on the phone as required primarily within the department and company and may include client contacts or other third-party depending on assignment with account holders, may dial manually when need or use dialer system; headset is also provided.

Occasionally lift/carry/push/pull up to 10lbs.

Education and Experience:

High School diploma or equivalent

2+ years’ experience in a call center or customer service position

1+ years claims processing/billing experience preferred but not required

Other Requirements:

Performant is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and clearances (as applicable).

Must submit to and pass pre-hire background check, as well as additional checks throughout employment.

Must be able to pass a criminal background check; must not have any felony convictions or specific misdemeanors, nor on state/federal debarment or exclusion lists.

Must submit to and pass drug screen pre-employment (and throughout employment).

Performant is a government contractor. Certain client assignments for this position requires submission to and successful outcome of additional background and/or clearances throughout employment with the Company.

Employment VISA Sponsorship is not available for this position

Job Profile is subject to change at any time.

EEO

Performant Financial Corporation is an Equal Opportunity Employer.

Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law.

NO AGENCY SUBMISSIONS WITHOUT PERFORMANT AUTHORIZEDAGENCY AGREEMENT AND APPROVED PERFORMANT JOB ORDER5.

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